Abstract
AimTo evaluate the patterns of loco-regional recurrences in head and neck cancer patientsMethodsTwenty-six out of 112 patients treated with primary or postoperative 3D CRT or IMRT for their primary and recurrent disease between 2007 and 2013 were included. The CT images of recurrent disease were rigidly registered with the primary CT images for each patient. To assess overlaps and overlap localization, the recurrence volume overlapping with the primary target volume was identified. For relapses occurring in the regional lymph nodes, the epicenter distance in recurrences and primary volumes and dose in recurrences were also identified. The recurrences were defined as in-field, marginal or out-of-field.ResultsThe majority of the failures occurred within 1 year after completed primary treatment. The dose differences in recurrence volume were not statistically significant when patients were treated with IMRT or 3D CRT. Recurrence in 15/26 of the included patients occurred in the regional lymph nodes located fully or partly inside the primary target volume or the elective lymph node region. The majority of recurrences were recognized as in-field, independent of the primary treatment.ConclusionRecurrence in the majority of the patients occurred in the regional lymph nodes located in high dose area. The cause of recurrence may be due to inadequate total dose in the primary treatment and/or lack of optimal primary diagnosis leading to inadequate primary target delineation.
Highlights
The incidence of oral cavity/pharynx and larynx cancer in Europe was estimated to 100,000 and 40,000, respectively, in 2012 [1]
To be included in the current study the following criteria had to be fulfilled: i) re-irradiation for first relapse in the head and neck region, ii) radiotherapy for both primary and recurrent disease at Oslo University Hospital, iii) Computed Tomography (CT), and/or Positron Emission Tomography (PET)/magnetic resonance images (MRI) taken prior to RT, iv) available RT dose plans for the primary and recurrent disease which were technically possible to co-register, v) completed their planned curative primary radiation treatment
In patients treated with postoperative RT compared to those treated with primary RT, the fraction of the recurrences occurring within 1 year was approximately 3 times higher
Summary
The incidence of oral cavity/pharynx and larynx cancer in Europe was estimated to 100,000 and 40,000, respectively, in 2012 [1]. In Norway, 800 patients were diagnosed with head and neck cancer (HNC) in 2014, representing 2.5% of the total incidence of malignant disease [2]. Management of HNC is multi-disciplinary; surgery, radiotherapy (RT) with or without concomitant. Johansen et al Radiation Oncology (2017) 12:87 recurrence to the original target structures. To address this issue, we have analyzed recurrence patterns in patients with recurrent HNC previously treated with 3D CRT and IMRT at our institution. A detailed mapping of the primary treatment, the patient dose distributions and subsequent recurrence patterns are provided
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
